Emami Infrastructure Doc.

No: EMAMI/H&S/FM-02
Limited Revision No: 00
Date: 01-May-2014

Emami Infrastructure Limited

H&S MONTHLY STATISTICS

REPORT
Contractor:
Project:

MONTH OF MAY-2014
1/5/2014
Report No:
DATE SUBMITTED

Submitted by:
SIGNATURE

Submitted To:

CC:

Page No. TABLE OF CONTENTS

1 FRONT PAGE

2 HEALTH AND SAFETY MONTHLY STATISTICS FOR MONTH OF MAY-2014

3 HIGHLIGHTS OF H&S ACTIVITIES FOR THE MONTH OF MAY-2014

HSE | HOD | BA 09
Signature: MAMI/H&S/FM-02
Project Mnager

HSE | HOD | BA 09
 Doc. No:
MONTHLY H&S STATISTICS EMAMI/
Emami H&S/FM-
PROJECT NAME :
Infrastructure PROJECT CONTRACT NO :
02
Revision:
Limited PROJECT START : 0
PROJECT FINISH : Date:
PROJECT MANAGER :

H&S DEPARTMENT CONSTRUCTION MGR :

Page: 1
HSE MANAGER :
FROM THIS UP TO
# Description of Items PROJECT MONTH LAST Current First Aid CasesPrevious
START (+ OR -) MONTH
0 HEAD HEAD 0
1 No of employees inducted 0 0 0
0 EYES EYES 0
0 FACE FACE 0
2 No of Tool Box Talks Conducted 0 0 0
0 NECK NECK 0
No. of Other Internal/External Trainings 0 ARM ARM 0
3
Coducted
0 0 0
0 HAND HAND 0
0 FINGER FINGER 0
4 No of Training Hours 0 0 0
0 TORSO TORSO 0
0 BACK BACK 0
5 No of Planned Inspection/Audits 0 0 0
0 UP LEG UP LEG 0
0 LOW LEG LOW LEG 0
6 No of HSE Meetings 0 0 0
0 FOOT FOOT 0
0 TOTAL 0
7 No. of Violation/Obsevations 0 0 0
CAUSES
0 Struck by falling material (SFM) 0
8 No. of Violation/Obsevations Closed 0 0 0
0 Trip or slip (TOS) 0
No. of Fatal or Permanent Disabling 0 Fall from height (FFH) 0
9
Injury
0 0 0
0 Handling of material (HOM) 0
No. of Lost Time Incident 0 Equipment/tools (TLS) 0
###
(>3Days off) / LTI 0 0 0
0 PPE misuse (PPE) 0
No. of Minor Injuries (3 to 1 day lost or 0 Electricution 0
###
recordable Injuries)
0 0 0
0 Other (ETC) 0
0 TOTAL 0
###No of First Aid Cases ( Non-Recordable) 0 0 0
KIND OF INJURY
0 Fracture (FRC) 0
###No. of near Misses Reported 0 0 0
0 Dislocation (DSL) 0
0 Cuts/Laceration (CTL) 0
###No of Fire Incidents 0 0 0
0 Abrasion/bruises (ABB) 0
0 Amputation (AMP) 0
###No of Vehicular Incidents 0 0 0
0 Burns (BNS) 0
0 Punchure (PNC) 0
###Total Hrs lost from recordable and LTI 0 0 0
0 Other (ETC) 0
Total days lost due to LTI and 0 TOTAL 0
###
recordable cases
0 0 0
COMMON SICKNESS
0 Head Ache (HA) 0
###No of tower/mobile cranes on site 0 0 0
0 Stomach Ache(SA) 0
0 Tooth Ache (TA) 0
###Average Number of Daily Employees NA 0 0
0 Body pain/Weakness 0
0 Heat Stress (HS) 0
###Total Man Days Worked 0 0 0
0 Dizziness (DZ) 0
0 Sore Eyes (SE) 0
###Total Man hours Worked (TMH WORK) 0 0 0
0 Sore Throat (ST) 0
0 Allergy (AL) 0
###Total Man hours from the Last LTI 0 0 0
0 Flu / Colds (FC) 0
Total number of LTI X 100,000 0 Hypertension/Hypotension (HY) 0
###FREQUENCY RATE #DIV/0!
Total hours worked 0 Urinary Track Infection (UTI) 0
Total days lost x 1000 0 Other (ETC) 0
###SEVERITY RATE #DIV/0!
HSE \ HOD | BA 09
###SEVERITY RATE #DIV/0!
Total hours worked 0 TOTAL 0

Signature:
Project Mnager EMAMI/H&S/FM-02

HSE \ HOD | BA 09
 Emami MONTHLY H&S STATISTICS PAGE
PROJECT NAME : 2
Infrastructure PROJECT CONTRACT NO :
MONTH
Limited PROJECT START :
PROJECT FINISH : May-14
PROJECT MANAGER :
H&S DEPARTMENT CONSTRUCTION MGR :
HSE MANAGER :

Hightlight of HSE Activites for MAY

1.0 Incident Reports

1.1
Date Name of Injured Person Nationality Trade Company Kind of injury Day Lost Return Date

Total days lost 0

1.2
1.3
1.4

2.0 Housekeeping
2.1
2.2
2.3

3.0 Violations/ Observations

3.1
3.2
3.3

4.0 Activities
4.1
4.2
4.3
4.4
4.5

5.0 Fire Fighting Capabilities Inspection

5.1
5.2
5.3

6.0 Plans for Next Month

6.1
6.2
6.3
6.4
6.5
6.6

7.0 Training Topics - Inetrnal /External

7.1
7.2
HSE | HOD | BA 09
7.3
Signature:
Project Mnager AMI/H&S/FM-02

HSE | HOD | BA 09